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203 Hospital-Wide Assessment of Patient Room Environmental Cleanliness

Friday, March 19, 2010
Grand Hall (Hyatt Regency Atlanta)
Mark E. Rupp, MD , University of Nebraska Medical Center, Omaha, NE
Ann Adler, RN , Nebraska Medical Center, Omaha, NE
Margaret Schellen , University of Nebraska Medical Center, Omaha, NE
Kyle Cassling , University of Nebraska Medical Center, Omaha, NE
Elizabeth Lyden, MS , University of Nebraska Medical Center, Omaha, NE
Teresa Fitzgerald, RN , Nebraska Medical Center, Omaha, NE
Lee Sholtz, RN , Nebraska Medical Center, Omaha, NE
Philip Carling, MD , Carney Hospital, Dorchester, MA

Background:   Environmental surfaces may become contaminated by a variety of potential pathogens and, unless adequately cleaned and disinfected, may serve as a source for transmission to healthcare providers and/or patients.

Objective: Assess environmental cleanliness of high-touch surfaces throughout inpatient units of an academic medical center.

Methods: A water soluble, ultra-violet fluorescent marking solution (DAZO Solution, P Carling, Boston, MA) was used to tag 10 high-touch surfaces in inpatient rooms.  Following patient discharge and terminal cleaning, the surfaces were assessed for adequacy of cleaning.

Results: In June and July of 2009, 120 patient rooms on 13 inpatient non-ICU units were surveyed.  817 of 1109 (74%) of high-touch surfaces were adequately cleaned. The rate of cleaning adequacy varied from unit-to-unit and ranged from 38% to 96% (P<0.001). The rate of adequate cleaning of high-touch surfaces in 26 contact isolation rooms compared to 94 non-isolation rooms was 80.4% and 66.5%, respectively.  As shown in Figure 1, in studies performed in 40 ICU rooms, there was no correlation between the amount of time that was spent by personnel cleaning the rooms and the adequacy of cleaning (Spearman r 0.037).

Conclusions: The UV-fluorescent tagging solution is a convenient means to assess adequacy of environmental cleaning.  Although overall 74% of surfaces were adequately cleaned, there was wide unit-to-unit variation.  The amount of time spent cleaning the room did not correlate with cleanliness.